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General NPI Number Information
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NPI Number | 1790383818
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Entity Type | Organization
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Legal Business Name | JOSHUA BAER OD INC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 3840 EL DORADO HILLS BLVD STE 103
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4567
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Country | US
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Telephone | 916-618-4832
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Fax |
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Provider Business Mailing Address
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Address Line | 3240 COLLINGSWOOD DR
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-6218
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Country | US
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Telephone | 714-326-5339
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA CHAD BAER
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Credential | OD
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Telephone | 714-326-5339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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